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m A detailed imaging and recording of the ocular

circulation by a series of photographs after the


administration of a dye

m This test is useful for assessing problems with


retinal circulation, such as those that occur in
diabetic retinopathy, retinal bleeding, and
macular degeneration to rule out intraocular
tumors
m Assess the client for allergies and previous
reaction to dyes

m Obtain informed consent

m A mydriatic medication, which causes pupil


dilation, is instilled into the eye 1 hour before the
test

m Dye is injected into the vein of the client¶s arm


m ánform the client that dye may cause the skin to
appear yellow for several hours after the test
and is eliminated gradually through the urine

m Encourage rest after the procedure

m Encourage fluid intake to assist in eliminating


the dye

m Urine might appear bright green


m Allows examination of the anterior ocular
structures under microscopic magnification

m The client leans on a chin rest to stabilize the


head while a narrowed beam light is aimed so
that it illuminates only a narrow segment of the
eye
m Explain the procedure to the client

m Advise the client about the brightness of the light


and the need to look forward at a point over the
examiner¶s ear
m ás used to primarily assess for an increase of
áOP and potential glaucoma

m Normal áOP is 10 to 21 mmHg

m Client must be instructed to avoid rubbing the


eye following the examination if the eye has
been anesthetized because of the potential for
scratching the cornea
m Assesses the mastoid, middle ear, and inner ear
structures

m Multiple radiographs of the head are obtained


m All jewelry is removed

m Lead eye shields are used to cover the cornea


to diminish the radiation dose to the eyes

m The client must remain still in a supine position


m Opacity of the lens that distorts the image
projected onto the retina and that can progress
to blindness

m Causes include the aging process (senile


cataracts), inherited (congenital cataracts), and
injury (traumatic cataracts)

m ánterventions is indicated when visual acuity has


been reduced to a level that the client finds to be
unacceptable or adversely affects his or her
lifestyle
m ðlurred vision and decreased color perception
are early signs

m Halos around lights

m Reduced visual acuity

m Presence of w white pupil

m Loss of vision
m þurgical removal of the lens, one eye at a time

m ánstruct the client regarding the postoperative


measures to prevent or decrease intraocular
pressure

m þtress to the client that care after surgery


requires instillation of different types of eye
drops several times a day for 2 to 4 weeks
m Administer eye medications preoperatively,
including mydriatics and cyclopegics as
prescribed

m After the surgery, elevate the head of the bed 30


to 45 degrees

m Turn the client to the nonoperative side

m Maintain an eye patch as prescribed; orient the


client to the environment
m Position the client¶s personal belongings to the
nonoperative side

m Use side rails for safety

m Assist with ambulation

m Use an eye shield at bed time


m A group of ocular diseases resulting in increased
áOP

m Results form inadequate drainage of aqueous


humor from the canal of þchlemm or
overproduction of aqueous humor

m The condition damages the optic nerve and can


result in blindness

m Gradual loss of visual fields may go unnoticed


m 6  
 


   £ results form obstruction to outflow
of aqueous humor

m r 
 
    £ follows an
untreated attack of acute closed-angle
glaucoma

m r 
 

    £ results from
overproduction or obstruction to the outflow of
aqueous humor
m 6     £ is a rapid onset of áOP
higher than 50 to 70 mmHg

m r 
    £ is a slow progressive,
gradual onset of áOP higher than 30 to 50 mmHg
m Diminished accommodation and increased áOP

m Loss of peripheral vision

m Decreased visual acuity

m Halos around lights

m Headache or eye pain


m Treat acute glaucoma as a medical emergency

m Administer medications as prescribed to lower


áOP

m Prepare the client for peripheral iridectomy,


which allows aqueous humor to flow from the
posterior to the anterior chamber
m Administer miotics, carbonic anhydrase
inhibitors, and betablockers as prescribed

m ánstruct the client of the need for lifelong


medication use

m ánstruct the client to avoid anticholinergic


medications

m ánstruct client to report eye pain and changes in


vision
m Prepare the client for trabeculoplasty as
prescribed to facilitate aqueous humor drainage

m Prepare the client for trabeculectomy as


prescribed, which allows drainage of aqueous
humor into the conjunctival spaces by the
creation of an opening
m Detachment or separation of the retina from the
epithelium

m Occurs when the layers of the retina separate


because of the accumulation of fluid between
them, or when both retinal layers elevate away
from the choroid as a result of a tumor

m Partial detachment becomes complete if


untreated, which can lead to blindness
m (lashes of light

m (loaters or black spots (signs of bleeding)

m áncrease in blurred vision

m þense of curtain being drawn over the eye

m Loss of a portion of the visual field


m Provide bed rest

m Cover both eyes with patches as prescribed

m þpeak to the client before approaching

m Protect the client from injury

m Avoid jerky head movements


m Minimize eye stress

m Prepare the client for a surgical procedure as


prescribed

m þcleral buckling, to hold the choroid and retina


togetehr with a splint until scar tissue forms,
closing the tear
m An inflammatory disorder usually caused by an
infection of the middle ear occurring as a result
of a blocked Eustachian tube, which prevents
normal drainage

m Common complication of an acute respiratory


infection

m ánfants and children are more prone


m (ever

m árritability and restlessness

m Loss of appetite

m Pulling on or rubbing the ear

m Ear pain

m Purulent drainage
m Encourage fluid intake

m (eed infants in upright position t prevent reflux

m Lie with the affected ear down

m Dry the ear by wicking


m Administer antipyretics as prescribed

m Administer antibiotics as prescribed

m þcreen for hearing loss

m ánstruct the parents about the procedure for


administering era medications
m Also called as endolymphatic hydrops

m Dilation of the endolymphatic system by


overproduction or decreased reabsorption of
endolymphatic fluid

m Characterized by w  w  



    w 

m þymptoms occur in attacks and last for several


days, and the client becomes totally
incapacitated during the attacks
m ánitial hearing loss is reversible but as the
frequency of attacks continue, hearing loss
becomes permanent

m Damage to the cochlea cause increase fluid


pressure leads to permanent hearing loss

m Caused by viral and bacterial infections, allergic


reactions, vascular disturbance
m (eelings of fullness in the ear

m Tinnitus

m Hearing loss

m Vertigo

m Nausea and vomiting

m Headaches
m Prevent injury during vertigo attacks

m Provide bed rest in a quiet environment

m Provide assistance with walking

m ánstruct the client to move the head slowly

m ánitiate sodium and fluid restrictions as


prescribed
m ánstruct the client to stop smoking

m Administer nicotinic acid (niacin) as prescribed


for vasodilatory effects

m Administer antihistamines as prescribed

m Administer antiemetics as prscribed

m Labyrinthectomy may be performed


m Dilate the pupils (mydriasis) and relax the ciliary
muscles (cyclopegia)

m Used preoperatively or for eye examinations

m Contraindicated with glaucoma

m Tropicamide (Mydriacil, Tropicacyl, Opticyl)


m Reduce áOP by constricting pupils and
contracting the ciliary muscle

m Open the anterior chamber angle and increase


the outflow of aqueous humor

m Pilocarpine hydrochloride (ásopto Carpine)


m ánterfere with the production of carbonic acid,
which leads to decreased aqueous humor
formation and decreased áOP

m Long term treatment for open angle glaucoma

m Acetazolamdie (Diamox)